Health, repatriation & medical care

MLC 2006 Regulation 4.1 (medical care on board and ashore) and Regulation 2.5 (repatriation) are the backbone of seafarer health protection. Combined with STCW Reg. I/9 (medical fitness) and IMO/ILO/WHO Joint Guidelines (2013), they fix what care you are entitled to, who pays, and how to invoke the system when something goes wrong.

Care entitlement at sea

• · Onboard care at no cost from the shipowner. Includes medical attention, supplies from the kit, and access to a TMAS doctor.
• · Onshore care at the next port if shipboard treatment is inadequate. The shipowner pays consultations, hospitalisation, surgery, dental treatment for emergencies. The shipboard medical officer documents the referral.
• · Continuing care after repatriation — up to 16 weeks of medical care and full wages for non-pre-existing illness/injury (MLC Standard A4.2.1).

Repatriation for medical reasons

• 1. Master / Medical Officer assesses fitness to continue duties; consults TMAS.
• 2. If unfit: master enters the assessment and decision in the OLB.
• 3. Company / DPA notified; manning agent arranges flight + escort if needed.
• 4. Repatriation under MLC Reg. 2.5 — at no cost to the seafarer; to the country of residence or as agreed in the SEA.
• 5. Continuing wages until contract end OR until a flag-state-defined period (typically 4 months for cargo ships under Standard A2.5.1).
• 6. Insurance follow-up: P&I correspondent or shipowner's medical insurer handles continuing-care invoices.

If the company stalls

• · DMLC Part II — locate the financial-security certificate posted on board; identify the insurer; contact directly.
• · Flag state — MLC Standard A5.1.5 complaint to the flag administration.
• · ITF Inspectorate — at the next port; can negotiate quickly via the FoC framework.
• · ISWAN SeafarerHelp — 24/7 multilingual triage and connection to local welfare network.
• · Port-state PSC — under the Tokyo / Paris / Indian Ocean MoU MLC inspection regimes, PSC can detain the vessel until the seafarer is repatriated.

Medical fitness — STCW + MLC

• · Vision: ≥6/6 corrected (Snellen) for deck; colour-discrimination tests (Ishihara plates) for deck only.
• · Hearing: ability to hear ordinary speech in one ear at 5 m, the other ear at 2 m.
• · Cardiovascular: no uncontrolled hypertension, no recent unstable angina, no high arrhythmia risk.
• · Respiratory: adequate FEV1; no recent active TB; no severe persistent asthma.
• · Mental health: no condition limiting decision-making in emergencies or fitness to perform safety duties.
• · Issued by an approved doctor on the flag state's list. Maximum validity 2 years.

Sources: MLC 2006 Reg. 2.5 + Standard A2.5; MLC Reg. 4.1 + Standard A4.1; MLC Reg. 4.2 + Standard A4.2.1 (financial security 2014 amendments); STCW Reg. I/9; ILO/IMO/WHO Joint Guidelines on Maritime Medical Examinations (2013). See also injury at sea, medical help, repatriation blocking, MLC abandonment.